Effect of Ureteroscopic Holmium Laser Lithotripsy on Stress Response and Renal Function in Patients with Complex Ureteral Calculi Complicated with Hydronephrosis
ZHAO Yanfu
YANG Yanfang
WEI Nan
LI Jing
Abstract：Objective To analyze the effect of ureteroscopic holmium laser lithotripsy(URHL)on stress response and renal function in patients with complex ureteral calculi complicated with hydronephrosis.Methods A retrospective study was conducted on 103 patients with complex ureteral calculi complicated with hydronephrosis admitted to Zhangjiakou First Hospital from February 2022 to February 2024.According to different surgical protocols,the patients were divided into the URSL group(54 cases)treated with ureteroscopic pneumatic lithotripsy(URSL)and the URHL group(49 cases)treated with URHL.Both groups were followed up for 1 month.Perioperative indicators,stress response at 1 day before and after sur-gery,renal function and hydronephrosis grading at 1 month before and after surgery,and the incidence of complications at 1 month after surgery were compared between the two groups.Results The URHL group had shorter operation time,shorter hospital stay,and higher complete stone clearance rate,with statistically significant differences(P<0.05).Compared with before surgery,the serum levels of adrenocorticotropic hormone(ACTH),norepinephrine(NE),and cortisol(COR)in both groups increased at 1 day after surgery,but those in the URHL group were lower,with statistically significant differenc-es(P<0.05).At 1 month after surgery,the levels of serum creatinine(Scr),blood urea nitrogen(BUN),urinary kidney in-jury molecule-1(KIM-1),and neutrophil gelatinase-associated lipocalin(NGAL)in both groups decreased,and those in the URHL group were lower,with statistically significant differences(P<0.05).Compared with before surgery,the hydrone-phrosis grading of both groups improved at 1 month after surgery,and the URHL group was superior to the URSL group,with a statistically significant difference(P<0.05).At 1 month after surgery,the incidence of complications in the URHL group[6.12%(3/49)]was lower than that in the URSL group[20.37%(11/54)],with a statistically significant difference(P<0.05).Conclusion Compared with URSL,URHL can reduce the stress response of patients with complex ureteral calculi complicated with hydronephrosis,improve perioperative indicators,enhance renal function,regulate hydronephrosis grad-ing,and reduce the risk of complications.
Keywords：complex ureteral calculihydronephrosisureteroscopic holmium laser lithotripsystress responsere-nal functioncomplications
Publication Date：2025-10-28
Online Publishing Date：2026-01-15(First online date of this platform, not the publication date of the document)
Pages：5( 316-320 )